Penn Valley Fire Protection District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PENN VALLEY FIRE PROTECTION DISTRICT

Doing business as

Penn Valley Fire Protection District

Practice address

10513 Spenceville Road
Penn Valley, CA 95946

Phone

(530) 432-2630

NPI assigned

Jan 29, 2007

Last updated

Sep 13, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald Eugene Wagner

Title

Fire Chief

Phone

(530) 432-2630

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Penn Valley Fire Protection District Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1346386257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959460180",
            "telephone_number": "530-432-2630",
            "fax_number": "530-432-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10513 SPENCEVILLE ROAD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "95946",
            "telephone_number": "530-432-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN VALLEY FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "530-432-2630"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00062F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Valley Fire Protection District",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ursula M Monroe, L. AC
• Joyce L Moore, ATC/PTA
• Brian Moreau
• Wendy Sue Nelsen
• New Edge Physical Therapy Inc (Wildwood Physical Therapy Inc)
• Penn Valley Seventh-Day Adventist Church (Helping Hands Caregiver Resource)
• Penn Valley Union Elementary School District
• David Peterson, D.C.
• Morgan Plumb
• Karen M Rinkleib, D.C.

• Land Ambulance in Penn Valley, CA
• Providers in Penn Valley, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.